Healthcare Provider Details

I. General information

NPI: 1053242131
Provider Name (Legal Business Name): DENISE BOYCE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4603 JOHN GARRY DR STE 15
COLUMBIA MO
65203-6834
US

IV. Provider business mailing address

18365 S OLD ROUTE A
HARTSBURG MO
65039-9806
US

V. Phone/Fax

Practice location:
  • Phone: 573-289-9500
  • Fax:
Mailing address:
  • Phone: 573-881-3639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2005017270
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: